Xavier Becerra backpedals on single payer as he woos powerful doctors’ lobby

Democratic candidate Xavier Becerra has softened his support for a single-payer healthcare system as he secures endorsements in his bid to be California’s next governor, most recently from the powerful doctors’ group, the California Medical Association, which officially backed him this week.

The former health secretary under President Joe Biden has advocated for government-run healthcare since he was a congressman 30 years ago. But when doctors with the medical association peppered the candidate with questions on single payer during a recent private meeting, they said Becerra told them he had other priorities.

“He said very clearly that, at this point, he wasn’t supportive of single payer,” said Dr. René Bravo, president of the California Medical Association.

The trade group for doctors is one of the most influential medical lobbies in California and has long opposed efforts to establish a single-payer system in the state, arguing it is not economically feasible and would erode physician autonomy. California lawmakers failed multiple times to pass legislation in support of single-payer in recent years. In 2022, legislative analysts estimated the cost of operating such a system could top $391 billion a year and said it would require passing new taxes on California residents and businesses.

The association endorsed Becerra in the crowded race for governor April 28, as he quickly rose to become a frontrunner in the two weeks after Eric Swalwell dropped out. Becerra’s sudden popularity in the polls and scramble to secure additional campaign financing have forced him to clarify the nuances of his policy positions, including single-payer.

Becerra’s campaign website links to a video of him testifying before Congress in 1994 in support of a single-payer plan, proclaiming, “Healthcare is a right, not a privilege.”

On March 23, 2026, the anniversary of the passage of the Affordable Care Act, Becerra wrote in a social media post: “I proudly helped write it, pass it, and defend it in court. Now I’m ready to go further as Governor and deliver single-payer health care for our state.”

But more recently, his message was significantly subdued.

“A single payer system is the right goal — but it’s not possible under this administration, and right now we have a crisis on our hands,” wrote Jonathan Underland, a campaign spokesperson, in a statement to KQED on Thursday. “Trump is slashing Medi-Cal and handing tax breaks to billionaires while millions of Californians risk losing their coverage.”

Indeed, Bravo relayed that Becerra said as much in his meeting with the medical association, telling the doctors his top focus was how to cope with the funding losses from H.R.1, President Donald Trump’s Big Beautiful Bill that is expected to drain $9.5 billion per year from California safety net programs, including Medi-Cal, which provides free health coverage to more than 14 million low-income Californians.

“The most important thing was making sure that we’re all on the same page in terms of how H.R.1 is going to affect the healthcare system in California, and how we’re going to ensure funding mechanisms that allow people to have access to care,” Bravo said.

Becerra told the doctors that now was not the time for single payer and that making any kind of progress on it while President Trump was in office was unrealistic.

For California to launch a single-payer system, it would need permission from the federal government to reallocate federal funding it receives for Medicaid and Medicare to the state’s new system, which the Trump administration almost certainly wouldn’t grant.

Becerra’s backpedaling on single payer is reminiscent of Gov. Gavin Newsom’s retreat on the issue: on the campaign trail for governor in 2018, Newsom touted his support of a single payer system, but once in office, he confronted the obstacles posed by the first Trump administration and shifted talk to universal access instead.

He supported legislation that expanded eligibility for insurance coverage to immigrants lacking permanent legal status, only to scale it back last year as the state faced a budget deficit and federal cuts.

Other Democratic candidates for governor have continued to voice ardent support of a Medicare-for-all type system, including Tom Steyer, Katie Porter, and Tony Thurmond. The two Republican candidates are steadfastly opposed.

State Assemblymember Ash Kalra, D-San José, who has backed recent single-payer bills in Sacramento, said Becerra sketched out a road map of how to set up a single-payer system while he was health secretary and “knows how to get it done.” But Kalra has endorsed Steyer for governor “because of his clear commitment” to advancing single-payer policy.

KQED’s Guy Marzorati contributed to this story.